Philadelphia Pennsylvania Limited Authorization to Inspect and Copy Medical Records

State:
Multi-State
County:
Philadelphia
Control #:
US-PI-0012
Format:
Word; 
Rich Text
Instant download

Description

This form grants authority to the attorney to obtain the client's medical records from the client's medical provider.
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How to fill out Philadelphia Pennsylvania Limited Authorization To Inspect And Copy Medical Records?

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Philadelphia Pennsylvania Limited Authorization to Inspect and Copy Medical Records